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Public Finance Lessons from Past National Tax Association Dissertation Award Winners

Paper Session

Friday, Jan. 4, 2019 2:30 PM - 4:30 PM

Hilton Atlanta, 305
Hosted By: National Tax Association
  • Chair: Enda Hargaden, University of Tennessee-Knoxville

What Does Health Care Billing Cost, and Why Does It Matter?

Abe Dunn
,
U.S. Bureau of Economic Analysis
Joshua D. Gottlieb
,
University of British Columbia and NBER
Adam Hale Shapiro
,
Federal Reserve Bank of San Francisco
Pietro Tebaldi
,
University of Chicago

Abstract

What does it cost physicians to interact with insurers in the byzantine U.S. health insurance system? We estimate these costs using rich data on the full set of interactions between a large sample of doctors and numerous different insurers. Our estimation assumes that providers maximize expected profits net of administrative costs, and that spending more effort implies a higher probability of receiving prompt payments from the insurer. Supporting this assumption, we find that physicians’ billing efforts are more successful when dealing with higher-value patient visits. We use the model’s estimates to understand what predicts physicians' billing efficiency, and whether billing costs influence the supply of care to different patients. Using identification strategies that control for practice-level unobservables and physician-level unobservables, we find that physicians are less likely to treat Medicaid patients when billing costs increase. We use these estimates to determine insurers’ optimal tradeoff between reimbursement rates and billing ordeals.

Program Recertification Costs: Evidence from SNAP

Tatiana Homonoff
,
New York University
Jason Somerville
,
Cornell University

Abstract

We document very low rates of recertification success among recipients of the Supplemental Nutritional Assistance Program (SNAP) – roughly half of cases fail to recertify in spite of maintained eligibility. We attribute many of these failures to procedural issues associated with the recertification process. Specifically, SNAP recipients – who must complete a recertification interview by the end of their recertification month – are 9 percentage points less likely to recertify if they are assigned an interview date at the end of the month rather than at the beginning, a 20 percent decrease. The results persist when conditioning on program eligibility and are larger for long-term SNAP recipients and households with children, suggesting that hassle costs associated with later interview dates worsen targeting efficiency both in terms of eligibility and need.

Do School Facilities Matter? Measuring the Effects of Capital Expenditures on Student and Neighborhood Outcomes

David Schonholzer
,
Yale University
Julien Lafortune
,
Public Policy Institute of California

Abstract

TBD
Discussant(s)
Brian Knight
,
Brown University and NBER
Dhammika Dharmapala
,
University of Chicago
David Albouy
,
University of Illinois and NBER
JEL Classifications
  • H0 - General
  • H2 - Taxation, Subsidies, and Revenue